| Application For Membership (Type or Print Clearly in Black ink) |
| I, the undersigned, respectfully petition to become a member of the Hard Core Confederates And if accepted, do hereby promise to comply with all organizational rules and bylaws. |
| _______________________________ Clearly Print Full Name |
| _______________________________ Legal Signature |
_____________________________________________________________________________________
Address City State Zip
Address City State Zip
______________________________________________________________________________________
Date of Birth State of Birth Occupation
Date of Birth State of Birth Occupation
______________________________________________________________________________________
Home Phone Cell Phone E-Mail Address
Home Phone Cell Phone E-Mail Address
| Recommended By ______________________________ |
| ( Initial Dues are $125.00 which include the Annual dues of $25.00). ______________________________________________________________________________ Administration Report |
____________________________
Date Application received
Date Application received
_______________________________
Date Approved
Date Approved
This application has been examined and according to Organizational guidelines the petitioner is approved for membership.
______________________________ __________________________
Founder Committee Chairman
______________________________ __________________________
Founder Committee Chairman
